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The study analyzed a cohort of 1082 patients with invasive urothelial bladder cancer who underwent radical cystectomy to evaluate the effect of variant histologies (VHs) on disease-specific survival (DSS). About 27.5% of patients had VHs, with squamous differentiation being the most common. Plasmacytoid and small-cell VHs were associated with worse DSS in the overall cohort, while clear-cell and small-cell VHs were associated with worse DSS in the organ-confined and node-positive cohorts, respectively. Accurate pathological diagnosis of VHs can help identify patients who require more intensive management
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